Value-Based Purchasing (VBP) Strategy

Introduction to VBP and Background Information

VBP Strategy Initatives:

Important Announcements

MaineCare Health Homes Initiative:  Re-opening of Practice Application for Participation

In order to support partnerships between primary care practices and community mental health agencies interested in participating in the Behavioral Health Homes initiative, MaineCare is re-opening its application for primary care practices that are not currently participating in Stage A Health Homes for MaineCare members with chronic conditions. 

Practices interested in participating in Stage B Behavioral Health Homes (for individuals with serious mental illness or serious emotional disturbance) are encouraged to apply.  Practices that apply and qualify will be eligible to participate in both Stage A and Stage B Health Homes initiatives as of April 1, 2014.  Practices that are already participating in Stage A Health Homes do no need to apply to participate in Stage B Behavioral Health Homes.  MaineCare will be following up separately with the existing Stage A practices to confirm participation in Stage B Behavioral Health Homes.

MaineCare currently has 159 Health Home practice sites across the state that, in partnership with Community Care Teams, deliver Health Home services to MaineCare members with chronic conditions through Stage A.  Stage B of MaineCare's Health Home initiative, being implemented in April 2014, requires partnerships between a primary care Health Home practice and one or more licensed community mental health providers (the Behavioral Health Home Organization or BHHO) to manage the physical and behavioral health needs of individuals with significant mental health needs. Through this application, practices may participate in both Stage A and Stage B of the Health Home initiative beginning in April 2014.

In order to participate, practices must:

  • Be participating MaineCare Providers;
  • Have received National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PPC-PCMH) Recognition within one (1) year from the date of enrollment;
  • Be located in the state of Maine;
  • Have a fully implemented Electronic Health Record (EHR);
  • Have or anticipate having an Memorandum Of Understanding/Memorandum Of Agreement (MOU/MOA) with at least one BHHO in its area;
  • Comply with MaineCare Benefits Manual, Ch. VI, Section 1-Primary Care Case Management, Section 1.08-5-Twenty-Four Hour Coverage;
  • Participate in Maine's multi-payer Patient Centered Medical Home (PCMH) Health Homes Learning Collaborative;
  • Within one year of the BHHO's participation, must fully implement Maine's multi-payer Patient Centered Medical Home/ Health Homes Core Expectations.

Completed applications are due by Friday, January 24, 2014. For practices with more than one location, a separate application must be completed for each location. Updated Due Date

To access the online application, please click here or go to: https://www.surveymonkey.com/s/BehavioralHealthHomesPracticeApp

Additional information about the Health Home and Behavioral Health Home initiatives can be found at MaineCare's Value-Based Purchasing Website: http://www.maine.gov/dhhs/oms/vbp/index.html

To review the current MaineCare regulation on Health Homes, please go to: http://www.maine.gov/sos/cec/rules/10/144/ch101/c2s091.doc

Questions about the MaineCare Health Homes initiative should be referred via email to Kitty Purington at OMS or to Lisa Letourneau, at Maine Quality Counts.

The Department of Health and Human Services has posted Requests for Applications (RFAs) for two initiatives under its Value-Based Purchasing Strategy, Accountable Communities and Behavioral Health Homes.

Behavioral Health Homes RFA (posted 10/11/13): http://www.maine.gov/dhhs/oms/vbp/health-homes/stageb.html

Accountable Communities RFA (posted 10/10/13):http://www.maine.gov/dhhs/oms/vbp/accountable.html

September 2013 Public Forums

Discussions during the 3 regional forums throughout the state consisted of the following:

  • Behavioral Health Homes Overview
  • State Innovation Model (SIM) Grant Context and Impact on VBP Initiatives
  • Accountable Communities Overview and Request for Applications

Forum Materials:

NCQA Recognition Due December 31, 2013

Health Home practices must achieve Patient Centered Medical Home (PCMH) recognition by the National Committee for Quality Assurance (NCQA) no later than December 31, 2013.

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Questions? Email Michelle Probert for questions about the project, upcoming events, and meetings.

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For more information about the VBP strategy, see the Resources or Archives pages.

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